Organization
MINNESOTA CLINICAL & NEUROPSYCHOLOGICAL ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS MICHAEL MISUKANIS PH.D. (OWNER)
(952) 876-0727
Entity
Organization
Contact information
Practice address
7800 METRO PKWY, SUITE 300, BLOOMINGTON, MN 55425-1514
(952) 876-0727
(952) 851-9618
Mailing address
7800 METRO PKWY, SUITE 300, BLOOMINGTON, MN 55425-1514
(952) 876-0727
(952) 851-9618
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
460980800
—
MN
Enumeration date
12/08/2006
Last updated
03/12/2009
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